The challenges of ethical research with children

As especificidades da pesquisa com crianças têm ganhado visibilidade nas produções acadêmicas em diversas áreas de conhecimento, com destaque para a Sociologia da Infância, principalmente a partir dos “novos estudos sobre a infância” os quais emergiram ao final da década de 1980. Essa visibilidade acontece devida a questões como: a discussão sobre as imagens da infância, construídas socio-historicamente; o reconhecimento da condição das crianças enquanto atores sociais, portanto, seres competentes, que atribuem significações a suas experiências e contextos; e o reconhecimento das crianças enquanto sujeitos de direitos, reconhecimento este pautado pela Doutrina da Proteção Integral. Permeadas por essas questões, as pesquisas com crianças agregam a questão da Ética nas atividades desenvolvidas na relação pesquisador-criança. No contexto dessa discussão, este trabalho propõe refletir sobre essas questões e os cuidados éticos nesse tipo de pesquisa, considerando a condição da criança enquanto sujeito de direitos. Foi realizado um recorte da produção acadêmica representativa na área da Sociologia da Infância nas duas últimas décadas, identificando quais aspectos aparecem nas preocupações dos autores, quais abordagens norteiam a discussão desses aspectos e, principalmente, que concepção de infância está presente nessa produção.The specificities of research with children have gained visibility in scientific publications in various areas of knowledge, especially in Sociology of Childhood and the “new studies of childhood”, which emerged at the end of the 1980s. This fact is due to discussions about childhood from a socio-historical perspective; the recognition of children as social actors and therefore able to give meaning to their experiences and contexts; and the recognition of children as individuals entitled to rights, according to the Doutrina da Proteção Integral (Full Protection Doctrine). Therefore, research ethics is an essential element of good research governance, especially in terms of activities related to the relationship between the researcher and child. Accordingly, the objective of this study is to examine and explore these issues, considering the child as an individual entitled to rights. A literature review of articles published in the last two decades in the area of Sociology of Childhood was conducted to identify the main issues and topics addressed, the approaches that guided the discussions and, especially, to identify the conception of childhood present in these studies.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portuga

Sport coaches' experiences of athlete injury : the development and regulation of guilt

This study sought to examine coaches’ stories of guilt in the specific context of athlete injury. Using narrative interviews with a diverse group of ten coaches, guilt was found to be a commonly experienced emotion that the participants also sought to regulate. The coaches’ experiences of the embodiment and management of guilt is primarily, although not exclusively, interrogated using the mainstream psychological theorising of Kubany and Watson (2003). The article concludes by connecting the coaches’ experiences of guilt with critiques of the prevailing deontological approach used to define what it means to be a ‘good’ sport coach. Here we suggest that dominant perspectives in coach education may be instrumental in entrenching coaches’ experience of guilt

Growing up beside you: a relational sociology of early childhood

This article will begin by outlining influential attempts by historians and sociologists to develop a more adequate theoretical understanding of past and contemporary childhoods, focusing on the major problems that stem from the pivotal role that ‘developmentalism’ plays in their arguments. I will argue that sociologists can overcome some of their deepest fears about the role of developmental psychology by developing a relational approach that integrates the biological and social aspects of children’s development. In the development of a relational sociology of early childhood we need to make important connections with closely related disciplines, but at the same time draw on and integrate research findings from relevant areas within the social and natural sciences. An alternative perspective drawn from the writings of Norbert Elias will be put forward and illustrated by discussing some of the key concepts that Elias and Vygotsky used to explain the language development of young children

Paradox in the pursuit of a critical theorization of the development of self in family relationships

This article starts with my dissatisfaction with the post-structuralist treatment of the production of subjectivity within regulatory discourses and practices due to its neglect of psychological processes. Taking starting points from within the history set out in the previous article, it highlights the paradox for critical psychologists like myself involved in both applying a post-structuralist critique to 'psy' discourses and trying to theorize subjectivity in a way that goes beyond the dualism of individual and society, of psychology and sociology. The relational, or intersubjective, approach to self that originates in object relations psychoanalysis as it emerged in the mid-20th-century UK is central to both of these activities; object of the former and resource for the latter. I explore the paradox that this creates for critical psychology, both epistemological and ontological. In aiming to provide a psycho-social account of self in family relationships, I deploy the radical conceptualisation of intersubjectivity initiated in British object relations theory as a way of going beyond both the individualized self and the neglect of psychological processes in constructionist theorizing subjectivity

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Contexts of Twinship: Discourses and Generation

Much of the research relating to twins is concentrated in biology and psychology where twins have been used as methodological tools for testing for the relative influences of nature and nurture. This chapter demonstrates a sociological approach to the study of twinship by situating twinship within a social and cultural context. It examines how discourses of twinship, childhood and ‘growing up’ bring meaning to and frame our understanding of twinship. It also draws attention to the significance of family life, especially family relationships and generation in contextualising twins’ experiences and variously facilitating and inhibiting their agency

Prevalence of tanning equipment use among Canadians

The objective of this study was to collect prevalence estimates of indoor tanning usage and associated injuries in Canada. The rapid response component of the 2019 Canadian Community Health Survey collected data on the use of tanning equipment in the previous 12 months, including reasons for use, frequency/duration of use, precautions taken and adverse reactions or injuries.The 2019 research findings were as follows, an estimated 3.0% (95% CI: 2.5–3.4%) of Canadians reported that they had used indoor tanning equipment in the past year. Among users, 71.1% (95% CI: 63.9–78.3%) were female and females aged 18–34 were significantly more prevalent users compared to females aged 45 or older. The prevalence of indoor tanning was higher among people without a university degree; however, there were no differences in prevalence by household income or region. Most users indicated they used indoor tanning equipment within a tanning salon (75.3%: 95% CI: 69.1–81.6%) and the most common reason for usage was to develop a “protective” base tan (72.1%: 95% CI: 65.2–78.9%). Over one third (39.2%: 95% CI: 31.1–47.2%) of all users reported 10 or more sessions in the past year.The prevalence of indoor UV tanning usage is declining in Canada. Similar to results in 2014, the majority of users continue to be female, with a large number in the 18 to 34 age group